ORDER FORM
Use this form only if your table is rectangular, square or round (circle) in shape and you already know which colors you want for your vinyl tops and felt bottoms

Send or Fax to:  
  PRESTIGE TABLE PADS                    
  9540 West Caravan Path 
  Crystal River, FL 34428
  Phone: 1-352-795-0107
  Fax: 1-352-795-0107 
 

 Please Print:
 Your Name:__________________________
 Address:____________________________
 City, State, Zip:_______________________
 E-Mail:_____________________________
 Telephone:__________________________


TABLE MEASUREMENTS
:
Measure only the flat surface of your table. Be sure to use a metal tape when measuring. Cloth and plastic measuring tapes will stretch and result in inaccurate measurements. Give measurements in inches.
SQUARE OR RECTANGULAR TABLE ROUND TABLE TABLE LEAFS
Length: ________ Width:________
How Many? ____
Diameter:_______
How Many? ____
Length____ Width____
How Many? ____

COLORS:
Circle your choice of colors from the selection below:

VINYL TOPS    

Aspen     Blonde      Bison     Fruit     Walnut     Mahogany    Palomino
Cherry     Cranberry     Ebony    Bisque     Chestnut      Maple

FELT BOTTOMS  

Rose     Ash     Caramel     Chocolate      Cinnamon
Burgundy     Sky Blue     Forest    Cocoa    Olive


PROTECTA PAD MEASUREMENTS:
:
Attach a separate sheet of paper indicating shapes, sizes, vinyl and felt colors and quantity for each.

PRICE STRUCTURE:

PADS AND LEAFS PRICES

SHIPPING AND HANDLING

 Table only up to 44" wide & 72" Long................$129.00
  Table 1 leaf up to 95" long....................................$155.00
  Table 2 leafs up to 95" long................... ..............$175.00
  Table 3 leafs up to 95" long..................................$195.00
  Table over 95" up to 120" long........................ ....$210.00
  Table 45" to 60" in width, add an additional ........$20.00
  Buffet or Server........................................................$79.00
  Coffee Table.............................................................$69.00
  Round or Square table up to 45"..........................$139.00
  Round or Square table 46" to 60..........................$169.00
  Each additional Leaf Pad........................................$30.00
  Protecta Pads........................................$.06 per square inch
  Table pads or Leaf Storage Bag ............................$19.95
  Eastern .....................................$20.00
  Central .......................................$22.00
  Mountain...................................$30.00
  Pacific.........................................$30.00
  Alaska and Hawaii     (Call for Rate)

METHOD OF PAYMENT:

Please check one: Money Order or Personal Check:___      Visa:____     Mastercard:____
Credit Card Number: ___________________________  Exp. Date: ________________
Customer's Signature:____________________________ Order Date: _______________

Please Note: There will be NO refunds given due to the fact that this is a custom made order, unless prior authorization is given.